Dealer Registration Form
* Customer Name :
*Cusomer Code :
Office Information
*Address :
*Country :
*State :
*City :
*Phone :   [Help]
*Pin Code :
Residential Information
*Address :
*Country :
*State :
*City :
General Information
*Mobile :  
*email Address :  
Website :
Whether any Group Co. already a customer of CFS (If yes, name them) :
Name of Authorised Person of Organisation :
Date of incorporation/Certifiate of Registration/operation Date :
<February 2012>
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*No. of years in business :
*Name of Promoter / Director / Partner/Proprietor :
*BU - (Contractor /Applicator/Distribution) :
login Information
*Login Name :
*Password :
Statutory Information
*Tin No. :
*Local Tax No. :
*CST No. :
ECC No., if applicable :
Excise Commisionarate, if applicable :  
Excise Division / Range, if applicable :
PAN Card No. :
*Assesse (mention whether Individual, Company, HUF, Firm etc.) :
Other Important Information
Nature of Business (Manufacturing/Construction/Trader etc.) :
Your Business Dealing Item :
Mention the Brand of Dealing Item :
Mention in brief your company history :
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